Transvaginal examinations and trauma

[dlcb98]

I gave birth 8 months ago and been suffering pelvic pain since and doctor wants me to go for an ultrasound on my pelvis. The ultrasound clinic informed me they may need to do a transvaginal ultrasound which I understand but it just makes me so anxious. I have suffered from a history of sexual trauma and I have found that these procedures are really triggering. I try and rationalize with myself and tell myself that it’s ok, it’s for my health, I’m consenting but it just doesn’t seem to work afterwards I still feel like I’ve been violated all over again and I just can’t shake it, leaves me abit warped afterwards tbh.
I had my smear which was just a bad experience as it went on for way too long- not what I was expecting also lead to me cancelling my pelvic floor physiotherapy as it was just too much.. I thought after giving birth and dealing with invasive experiences I’d be able to do these things but it just seems like it was easier to do because I was pregnant and for the sake of the baby.
Now I don’t know much about the reasoning behind doing a transvaginal ultrasound other than it being a clearer picture? I also clearly don’t want to jeopardize my health but is it worth re-traumatizing myself for a clearer picture like does make a difference? Has anyone else experienced this dilemma? Did it affect their diagnosis of the problem? Thanks in advance

I'm sorry for your trauma, but I think you want to get this moved to women's health.

This is genealogy, not gynaecology.

Oh god I didn’t even realize thank you!

I hope you find people who can give you useful advice.

Hi Op

I've had a few trans vaginal scans and many smears and the scans are by miles easier

They use loads of lubricant and seem able to insert the probe without even looking and then they just gently move it around.

They don't start stretching you open like they do with a smear and they don't peer up there..

I find them far less intrusive.

Have you tried inserting the scanner yourself? I have similar problems and also needed transvaginal ultrasounds, and the hospital staff were always fine with me asking to insert it myself

I had one 8 weeks after giving birth, having had a torn episiotomy and stitches. It was way easier than having a smear.

If you report your own OP you can ask MNHQ to move the whole thread for you.

As for your question, I am sorry to hear about your trauma OP. Yes, sometimes the clarity of the internal scan is necessary for accurate diagnosis. Are you able to speak to the department in advance so they can talk you through the process - would that help? As for the TV ultrasound itself, I find smear tests with a speculum extremely difficult to the point of putting them off for months, I found the Tv scan however to be far less intrusive and easier to deal with mentally, or though everyone is different of course, but just letting you know my experience.

so I have had a transvaginal ultrasound before when I had a miscarriage and I don’t think think it’s just the looking it’s something going in and I guess it’s the feeling of something going in while not aroused? I don’t know if that makes sense but that’s the only way I can think of explaining it

Hello

I’ve had exactly the same experience OP. I sobbed through my last smear because of it and had a good chat with the nurse about it. She said it’s actually more common than you’d think and advised in future to let the practitioner know before they start that you find it difficult due to previous trauma. Don’t need to go into the detail with them, but it meant that she could use a smaller speculum which really helped. She also said that a GP might be able to prescribe some diazepam that you can take just prior to the exam which should help relax you.

Hope this helps

No I’ve didn’t know you could do this? Is this something they allow? This could help. Do they still hold it afterwards once it’s in? Just curious as this could make it bearable for me. Thank you

I'm a sonographer, I wouldn't have any issue at all with you putting the probe in yourself, and I'll often offer the option to patients in pain / nervous.
I'd definitely need to take over holding it after that though as I know where I need to angle it.
I'd always try and make time to talk people through it, if I were you I think I'd say that your nervous early on but you don't need to go into details.
However, it might be an idea to attempt to contact the department beforehand so that they know that you are nervous beforehand, then hopefully they can allow you a bit more time in your appointment.

That makes complete sense, in your opinion as a Sonographer does it make a big difference not having it and just the external ultrasound? Would there be an option to go on the external scan and if they think they need a closer look for accuracy or does it not work like this? How big is the risk of them missing something not having a transvaginal ultrasound opposed to just having the external one?

You can have the external scan, but an internal is usually optimal.
Again, if you were my patient and asked
I'd happily try to do the external scan first (attend with a full bladder), but without being the person scanning you at that time I've no idea if the view would be good enough.
Your best bet is to talk to your sonographer, they won't make you do anything you don't want to but will let you know if it would be best